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Case management programs

In certain health situations, members are eligible to work one-on-one with a case manager. You may be eligible for a case manager if you:

• Have a qualifying complex or chronic disease
• Are at risk for developing a complex and serious medical condition (This may be determined by your answers to the Health Risk survey that you completed during enrollment.)
• Have been involved in an accident or other catastrophic health event
• Need assistance managing your health care needs

Case managers are available at no additional cost, but copayment and coinsurance for covered services may apply. Case managers can help you:

• Learn more about your disease, your benefits and available medications
• Identify and monitor your health care needs
• Apply self-management strategies
• Eliminate obstacles to receiving care
• Navigate the health care system
• Locate resources in your community

As a member of Blue Medicare HMO or Blue Medicare PPO, you may be eligible to receive disease-specific information, resources and support through our partnership with Accordant Health Services, Inc. The AccordantCare program aims to reduce the frequency and severity of crisis events for members who have any of the following chronic conditions:

• Multiple Sclerosis
• Parkinson's Disease
• Systemic Lupus Erythematosus (SLE)
• Myasthenia Gravis
• Sickle Cell Disease
• Cystic Fibrosis
• Hemophilia
• Scleroderma
• Polymyositis
• Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP)
• Amyotrophic Lateral Sclerosis (ALS)
• Dermatomyositis
• Gaucher Disease

The AccordantCare program features a full range of support services, including:

• 24-hour telephone access to nurse specialists and a team of health care
• Personalized health evaluations by phone or Internet to help identify early warning signs of potential complications and learn preventive self-care strategies
• Regular communications with your physicians alerting them to changes in your health status and specific health needs
• Customized educational materials, including brochures and monthly newsletters, with useful information about chronic conditions and tips for managing your condition

For more information about the AccordantCare program, visit the Accordant Web site or call toll free 1-800-948-2497.

To request services from a Blue Medicare HMO or Blue Medicare PPO case manager, please contact Customer Service 7 days a week, 8am to 8pm:

Blue Medicare HMO

1-888-310-4110

Blue Medicare PPO

1-877-494-7647

For the hearing and speech impaired

1-888-451-9957 (TTY/TDD)

Seven days a week
8 a.m. - 8 p.m.

Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change on January 1, 2011. Please contact Blue Medicare HMO, Blue Medicare PPO or Blue Medicare Rx (PDP) for details.

Blue Cross Blue Shield of North Carolina (BCBSNC) is a Medicare Advantage organization with a Medicare contract to provide HMO and PPO plans. BCBSNC does not discriminate based on color, gender, religion, national origin, age, race, disability, handicap, sexual orientation, genetic information, source of payment or health status as defined by the Centers for Medicare & Medicaid Services (CMS). All qualified Medicare beneficiaries may apply. You must be entitled to Medicare Part A and enrolled in Medicare Part B and must reside in the CMS-approved service area. You must continue to pay your Medicare Part B premium, if not otherwise paid for under Medicaid or another third party. BCBSNC is an independent licensee of the Blue Cross and Blue Shield Association.

The information on this page is current as of 10/01/2009.